Wednesday, 23 January 2013

One year after the
introduction of the Specials Tariff, the APSM (Association of Pharmaceutical
Specials Manufacturers) reports that the Tariff appears to have been successful
in restoring confidence to the market, but says there is little evidence to
date that this is having a positive impact on prescribing levels.

A poll of
pharmacists by Opinion Health showed
that almost half are happier prescribing specials now that a tariff is in
place.But although latest figures from
NHS Prescription Services show a gradual increase in the number of specials ordered
month-on-month from November to June, the APSM challenges any interpretation that
this is a sign of growth.It is more
likely a reflection of improved reporting by pharmacists and the DOH where
prior to the Tariff, special scripts were frequently classified as ‘other’
rather than ‘unlicensed medicines’.

Says Sharon
Griffiths, Vice Chair of the APSM, “Our feedback from our members and the
industry as a whole is that the specials market is static at best.We think this is partly due to reorganisation
and adjustment in the market as some pharmacists review their purchasing
arrangements post-Tariff.”

“However, we are
concerned that this could a sign of other factors at play, notably the
continued pressure by PCTs to reduce prescribing of specials.The NHS data also shows a corresponding
decrease in the overall cost of specials over the same time period.This is in part a reflection of the
effectiveness of the tariff in levelling off the pricing of specials but it
could also signal a reduction in specials prescribing overall.”Research by the APSM suggests that as many
of 40% of pharmacists have been asked to reduce specials dispensing, whilst
more than 50% of GPs had been requested to reduce or review prescribing
patterns.

If PCTs continue to
exert pressure to reduce prescribing, the end result could be that the patient
suffers because they do not receive the medication they need.

At the moment the
signs are that prescribers recognise the vital importance of specials and are
keeping patient need as their top priority.A survey amongst 200 GP’s showed that 54% had been asked by their PCT to
reduce specials prescribing – although not all had decided to act on this.

Pharmacists are
telling APSM members that they are also being asked to review spend on
specials, but most don’t want to shop around as they are concerned that this
can be time consuming and potentially risky.Many are dispensing less than 10 specials prescriptions a month and
would prefer the consistency of a specials supplier or suppliers that they know
and trust.

For this reason,
the APSM believes that patient need and quality is as important as overall cost
and this will ensure a sustainable and high quality specials sector that can
continue to invest in the infrastructure needed to ensure patient safety
remains a priority.

The APSM is
embarking on new educational and promotional initiatives over the coming
months, working with stakeholder groups to ensure that the knowledge and tools
are available to help all those involved in specials from prescriber to
patient.

The APSM has
recently launched a fact sheet ‘what to look for in a specials
manufacturer’.

At the same time,
membership of the APSM is stronger than ever and the commitment of members is
to continue to share best practice and invest in manufacturing and quality
processes.Members as a whole have
invested in excess of £150m in equipment and facilities across their UK
manufacturing plants in recent years.